DR. PRATIK DILIP PATEL M.D.
NPI 1235572686
Family Medicine in Spring, TX

Q: What is Pratik Patel's NPI number?

The NPI number for Pratik Patel is 1235572686. It was assigned to this individual provider in the NPPES registry on April 15, 2013.

Q: What is Pratik Patel's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Pratik Patel was last updated on April 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 15, 2013PECOS EnrolledAccepts Medicare Assignment

21309 FOSTER RD, STE 100, SPRING, TX 77388(281) 587-1700(281) 907-6003 Get Directions Write a Review

NPPES record last updated: April 29, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 29, 2021, Aug 15, 2018, Oct 20, 2017 and 1 more (4 updates tracked since 2016).

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About Dr. Pratik Dilip Patel M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PRATIK DILIP PATEL M.D. (NPI 1235572686) is an individual family medicine provider in Spring, Texas, licensed in Texas (R2438) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Memorial Hermann Hospital System, and maintains a secondary practice location in Conroe.

NPPES Registry Identity

NPI1235572686

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. PRATIK DILIP PATELCredential: M.D.

Location Address21309 FOSTER RD, STE 100Spring, TX 77388

Mailing Address21309 Foster Rd, Ste 100Spring, TX 77388-4209 · (281) 587-1700 · Fax (281) 907-6003

Phone(281) 587-1700

Fax(281) 907-6003

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateApril 15, 2013

Last NPPES UpdateApril 29, 20214 updates tracked since enumeration

NPPES CertifiedApril 29, 2021

✔ NPI 1235572686 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in TX · R2438✔ Licensed in TN · 54717

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

21309 FOSTER RD, Spring, TX 77388

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Secondary Practice Location 1

Location 111026 Highway 242Conroe, TX 77385-4348 · Phone (281) 587-1700 · Fax (261) 907-6003

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Blue Cross and Blue Shield of Kansas, Inc., Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Pratik Dilip Patel M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284874645

PECOS Enrollment IDI20171102000816

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

499 services331 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

155 services28 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

152 services152 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

150 services150 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

147 services27 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

145 services145 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

122 services104 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

50 services43 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

42 services33 patients

Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month 99489

Complex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.

40 services18 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

32 services32 patients

Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487

Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.

21 services18 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

20 services20 patients

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) G0506

This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.

19 services19 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

17 services17 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

16 services16 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

15 services15 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

14 services14 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

13 services13 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hermann Hospital System

Acute Care Hospitals · Houston, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450184

Location1635 North Loop WestHouston, TX 77008 · Harris County

Emergency services Birthing friendly

Hca Houston Healthcare Tomball

Acute Care Hospitals · Tomball, TX

2/5 CMS rating

OwnershipProprietary

CMS Certification Number450670

Location605 HolderriethTomball, TX 77375 · Harris County

Emergency services Birthing friendly

Houston Methodist Willowbrook Hospital

Acute Care Hospitals · Houston, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450844

Location18220 State Highway 249Houston, TX 77070 · Harris County

Emergency services Birthing friendly

Houston Methodist The Woodlands Hospital

Acute Care Hospitals · The Woodlands, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number670122

Location17201 Interstate 45 SouthThe Woodlands, TX 77385 · Montgomery County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77388 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.40 typical visit price

range $58.24 – $176.98

Typical copayment $22.60 (range $14.56 – $44.24)

Most-billed visit code 99203

Established Patient

$102.71 typical visit price

range $18.60 – $143.93

Typical copayment $25.67 (range $4.65 – $35.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LADYJOAN BOX NP

Nurse Practitioner (Family)

21309 FOSTER RD, STE 100
SPRING, TX 77388

Harris County (281) 587-1700

ALEJANDRA PALMEROS-IRVINE MD

Family Medicine

21309 FOSTER RD, SUITE 100
SPRING, TX 77388

Harris County (281) 587-1700

MILINDA MARIE DAVILA ANP

Nurse Practitioner (Family)

21309 FOSTER RD
SPRING, TX 77388

Harris County (281) 587-1700

DR. ANNA O LAVROVA MD

Internal Medicine

21309 FOSTER RD
SPRING, TX 77388

Harris County (281) 587-1700

SHANNON BLACKBURN FNP-C

Nurse Practitioner (Family)

21309 FOSTER RD
SPRING, TX 77388

Harris County (281) 587-1700

IKP FAMILY MEDICINE P.A.

Family Medicine

21309 FOSTER RD, STE 100
SPRING, TX 77388

Harris County (281) 587-1700

TIMOTHY E. IRVINE MD

Family Medicine

21309 FOSTER RD, SUITE 100
SPRING, TX 77388

Harris County (281) 587-1700

DANIELLE DAVIS BOSS FNP-C

Nurse Practitioner (Family)

21309 FOSTER RD, STE 100
SPRING, TX 77388

Harris County (281) 587-1700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pratik Patel's NPI number?

The NPI number for Pratik Patel is 1235572686. It was assigned to this individual provider in the NPPES registry on April 15, 2013.

Where is Pratik Patel located?

Pratik Patel practices at 21309 Foster Rd Ste 100, Spring, TX 77388. The listed phone number is (281) 587-1700.

What is Pratik Patel's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Pratik Patel enrolled in Medicare?

Yes. Pratik Patel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Pratik Patel accept?

Health plans from AvMed, Blue Cross and Blue Shield of Kansas, Inc., Blue Cross and Blue Shield of Texas, Community Health Choice and UnitedHealthcare list Pratik Patel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Pratik Patel affiliated with any hospitals?

According to CMS data, Pratik Patel is affiliated with Memorial Hermann Hospital System, Hca Houston Healthcare Tomball, Houston Methodist Willowbrook Hospital and Houston Methodist The Woodlands Hospital.

When was this NPI record last updated?

The NPPES record for Pratik Patel was last updated on April 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.